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The cost-effectiveness of grid laser photocoagulation for the treatment of diabetic macular edema: results of a patient-based cost-utility analysis

Sharma, Sanjay MD, MSc (Epid)*; Brown, Gary C. MD, MBA; Brown, Melissa M. MD, MBA; Hollands, Hussein; Shah, Ganrav K. MD§

Current Opinion in Opthalmology: June 2000 - Volume 11 - Issue 3 - p 175-179
Retina and vitreous disorders
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Grid laser therapy has been demonstrated to be of benefit for the treatment of diabetic macular edema. The purpose of the present study was to determine the cost-effectiveness of grid laser therapy for the treatment of diabetic macular edema. The analysis was performed from the perspective of a third-party insurer. Decision analyses and cost-effectiveness analyses were performed by incorporating the data from the Early Treatment Diabetic Retinopathy Study, expected longevity data, and patient-based utilities. Various sensitivity analyses were performed to determine the robustness of the models. Laser treatment conferred an overall improvement in quality-of-life adjusted years of approximately 3 months over the duration of disease for a hypothetical patient. The unadjusted cost per quality-of-life adjusted year (QALY) was US$3,101. Net present value analysis demonstrated that the cost per QALY could increase to $3,655, assuming a 5% discount rate. Overall, grid laser photocoagulation for diabetic macular edema is a very cost-effective treatment based on the results of this cost–utility analysis.

*Unit for Cost-Effective Ocular Health Policy, Kingston, Ontario, Canada; Center for Evidence-Based Healthcare, Philadelphia, Pennsylvania, USA; Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada; §Assistant Clinical Professor, Washington University, St. Louis, Missouri, USA

Correspondence to Sanjay Sharma MD, MSc, Unit for Cost-Effective Ocular Health Policy, Hotel Dieu Hospital, Brock 2, 166 Brock Street, Kingston, Ontario, K7L 5G2, Canada

© 2000 Lippincott Williams & Wilkins, Inc.